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Over the past two decades, hundreds of hospital mergers have escaped federal antitrust scrutiny and led to both higher prices and less competition, a new study shows.

But the study’s authors, and other researchers, believe the Federal Trade Commission’s hands often are tied. The agency simply doesn’t have enough money or people to crack down on all anticompetitive hospital deals, and some state laws shield hospital mergers from federal review completely.

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“The resources available are just not commensurate with what the agency needs,” said Zack Cooper, an associate professor of health policy and economics at Yale University and one of the co-authors of the study. “This isn’t a story of the FTC not knowing what to do. I actually think they really know, very clearly, what to do. It’s a lack of resources, person power, and potentially willingness to do it.”

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